THE RISE TEAM

RESPIRATORY THERAPISTS

Respiratory therapists have a specific significance on the early mobility team: They help compromised lungs supply the oxygen patients need to move. See how they do it.

MINIMIZE DAYS ON THE VENTILATOR

3 fewer days on the ventilator([FOOTNOTE=*For patients following an early mobility intervention in seven institutions, compared to patients in same institutions before the intervention. Balas MC, Vasilevskis EE, Olsen KM, et al. Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility (ABCDE) bundle. Crit Care Med, 2014;42(5):1024–1036. doi: 10.1097/CCM.0000000000000129],[ANCHOR=],[LINK=])*

Ventilator-associated events (VAEs) are linked to a variety of adverse outcomes, such as:

For respiratory therapists, early mobility greatly resembles patient transport. In both situations, therapists focus on patient-ventilator interactions, including adjusting the ventilator prior to a session and responding to changes during mobilization.

As with patient transport, the respiratory therapist must maintain control of the ventilator circuit and airway during all patient position changes.([FOOTNOTE=Archer, DA. Early Mobility in ICU: Respiratory Therapy Role in Mobilizing Ventilated Patients. Accessed June 13, 2017],[ANCHOR=View Conference Notes],[LINK=https://depts.washington.edu/pulmcc/conferences/lungday/Archer.pdf ])

Clinicians may consider mechanical ventilation a barrier to early mobility. But the true barrier may be lack of training on how to do so safely.7,([FOOTNOTE=Schweickert WD, Pohlman MC, Pohlman AS, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373:1874–1882. doi: 10.1016/S0140-6736(09)60658-9],[ANCHOR=],[LINK=]) For example, ICU teams have addressed one key concern, accidental extubation, through staffing and the use of an endotracheal securement device.4